Dr Francesco Lo Monaco shares the habits we should adopt to help prevent heart failure - Credit Andrew Crowley
The Six Most Important Things You Can Do Today to Stop Heart Failure
By Ella Nunn
UK
We all know about the dangers of a heart attack or stroke. But heart failure? For many, that’s where our medical knowledge gets hazy. The name sounds as if the heart has simply given up, but the reality is more nuanced.
“It means the heart can no longer pump blood around the body as efficiently as it should,” explains Dr Francesco Lo Monaco , a cardiologist at The National Heart Clinic on Harley Street. “It’s usually the result of damage that has built up over many years, rather than something that happens overnight.”
While treatments are better than ever, cases are rising. The culprits? Increasing rates of obesity, type 2 diabetes, and high blood pressure, coupled with our increasingly sedentary lives. As Dr Lo Monaco puts it, we are living through a perfect storm for cardiac decline. Experts writing in the European Heart Journal recently reinforced the message that the biggest opportunity to tackle heart failure lies not in treating it once it develops, but in preventing it and identifying risk factors early.
The challenge is that heart failure often develops silently. By the time symptoms such as breathlessness, persistent fatigue or swollen ankles appear, the condition may already be well established.
The good news is that much of the risk is preventable. Here, Dr Lo Monaco shares six habits you can start today to protect your heart for the long haul.
1. Check your blood pressure
“Knowing your blood pressure is important because high blood pressure is one of the leading causes of heart failure,” Dr Lo Monaco says. It forces the heart to pump harder against increased resistance, which over time causes the heart muscle to become thickened, stiff and eventually weaker at pumping blood efficiently.
“If you’re over 40, I recommend having your blood pressure checked at least once a year, and more frequently if it’s elevated or you have other risk factors,” Dr Lo Monaco says. “For most people, we aim for around 120/80 mmHg, although targets should always be individualised.”
A wealth of research shows that controlling blood pressure pays dividends. In one New England Journal of Medicine study, people at high cardiovascular risk whose systolic blood pressure (the top number in your reading, which measures the pressure in your arteries when the heart beats) was intensively treated to below 120 mmHg were 25 per cent less likely to experience a heart attack, stroke or heart failure than those treated to a target below 140 mmHg.
Meanwhile, a major meta-analysis in The Lancet found that every 10 mmHg reduction in systolic blood pressure reduced the risk of heart failure by around 28 per cent.
Fortunately, there’s plenty we can do to lower blood pressure. Dr Lo Monaco recommends “maintaining a healthy weight, reducing salt, eating plenty of fruit and vegetables, exercising regularly, sleeping well, managing stress and limiting alcohol”.
2. Move more every day
Exercise is one of the most powerful things we can do for our hearts. More specifically, cardiovascular exercise “improves the function of our blood vessels, making them more flexible and helping them dilate more effectively,” Dr Lo Monaco explains. “It also lowers blood pressure, improves cholesterol, reduces inflammation and helps maintain a healthy weight.”
Cardiovascular exercise keeps blood vessels healthy by making them more flexible and able to dilate more effectively - Credit Morsa Images/Abel Mitja a Varela
He recommends at least 150 minutes of moderate-intensity exercise each week – such as brisk walking, cycling or swimming – or 75 minutes of vigorous exercise like running or high-intensity fitness classes. Simply walking a little faster and a little further each day is a good place to start. “Regular movement throughout the day, taking the stairs, walking after meals and even standing more often all contribute to better long-term heart health.”
One study published in Circulation found that adults completing 150 to 300 minutes of moderate physical activity each week had a 63 per cent lower risk of heart failure than those doing very little exercise. Those completing 75 to 150 minutes of vigorous exercise each week had a 66 per cent lower risk.
Additionally, Dr Lo Monaco encourages strength training at least twice a week “because maintaining muscle mass supports both metabolic and cardiovascular health”. Recovery matters too. “Many people think more exercise is always better, but your heart becomes stronger during recovery,” he says. “Good quality sleep, rest days and allowing your body time to recover help regulate blood pressure, reduce inflammation and maximise the cardiovascular benefits of exercise.”
3. Set yourself a bedtime – and stick to it
Both the quality and consistency of your sleep are important, according to Dr Lo Monaco. “Most adults should aim for seven to nine hours of sleep each night, but keeping a regular bed time and wake up time helps regulate your body’s internal clock, blood pressure and hormone levels.”
He often tells patients they “don’t have time not to sleep”, with poor quality sleep raising the risk of high blood pressure, diabetes, obesity, heart rhythm problems and, ultimately, heart failure. In fact, one recent study published in The BMJ found that sleeping fewer than seven hours a night was associated with a 20 per cent higher risk of heart failure. Habitual snoring was also linked to a 20 to 30 per cent greater risk.
“I recommend avoiding screens for an hour before bed, limiting caffeine later in the day and creating a cool, dark sleeping environment,” Dr Lo Monaco says. “If you snore loudly or wake up feeling exhausted despite sleeping enough, it’s important to be assessed for sleep apnoea, as this is a common but often overlooked cardiovascular risk factor.”
4. Build your diet around whole foods
We often hear about the powers of omega-3 fatty acids for heart health. “They help reduce inflammation, lower triglyceride levels and support healthy blood vessel function,” Dr Lo Monaco says. “I generally recommend eating at least two portions of fish each week, with one of those being oily fish like salmon, sardines and mackerel.”
That said, “heart health isn’t about eating one ‘superfood’,” he adds. “It’s about your overall dietary pattern. I encourage my patients to follow a Mediterranean-style diet with plenty of vegetables, fruit, legumes, nuts, olive oil and lean sources of protein.”
Oily fish such as sardines are high in omega-3 fatty acids, which have numerous heart health benefits - Credit Dulezidar/iStockphoto
A landmark study published in The New England Journal of Medicine found that a Mediterranean diet supplemented with extra-virgin olive oil reduced the risk of major cardiovascular events by 31 per cent among people at high cardiovascular risk. A Mediterranean diet supplemented with mixed nuts reduced the risk by 28 per cent.
At the same time, Dr Lo Monaco advises cutting back on ultra-processed foods, processed meats, sugary drinks, fried foods and foods high in salt. “These contribute to high blood pressure, obesity, diabetes and cardiovascular disease,” he explains. “My philosophy has always been that you don’t need to change everything overnight. Start with one healthier choice, make it a habit, and then build from there.”
5. Stop eating three hours before bed
Another simple habit that may benefit both your sleep and diet is to avoid eating for at least three hours before bedtime. “I also advise avoiding alcohol, heavy or high fat meals, spicy foods and sugary snacks late in the evening,” Dr Lo Monaco says.
“These can disrupt sleep, trigger acid reflux, stimulate the nervous system and even increase the likelihood of palpitations in some people,” he explains. One study found that consuming more than 40 per cent of your daily calories after 7pm was associated with poorer blood vessel function and a higher prevalence of carotid plaques – fatty deposits in the arteries supplying blood to the brain.
“The goal is to give your body and your heart the best chance to recover overnight,” Dr Lo Monaco concludes.
6. Take five minutes to breathe
Chronic stress takes a toll on the cardiovascular system. “It raises stress hormones, increases blood pressure, disrupts sleep and often leads to unhealthy habits such as poor diet or inactivity, all of which increase the risk of heart disease and heart failure.”
In fact, one study published in the International Journal of Cardiology found that people with higher levels of stress hormones had a 63 per cent greater risk of cardiovascular disease.
There’s no single best way to manage stress. But even five to 10 minutes of slow, controlled breathing each day can help lower stress levels and improve overall wellbeing, says Dr Lo Monaco. The best approach is the one you’ll actually stick to – whether that’s yoga, meditation, mindfulness, box breathing or simply going for a walk outdoors.
Dr Lo Monaco also encourages his patients to think about stress more broadly. “Regular exercise, good quality sleep, strong social connections and making time to switch off are all powerful ways to protect both your mental wellbeing and your heart,” he says. “Prevention is built on daily habits, not occasional healthy choices.” – The Telegraph
